Electronic Visit Verification (EVV): Vendor Required Exception and Rejected Record Handling

Electronic Visit Verification (EVV): Vendor Required Exception and Rejected Record Handling

 

Process for Alternate EVV Exceptions and Rejected Records

If you are a MaineCare provider using an Alternate EVV vendor for your EVV system, continuous communication with the vendor is critical to the success of the Alternate EVV integration process. Prior to implementation of the Alternate EVV system, you and your Alternate EVV vendor must have a process to resolve Alternate EVV exceptions and rejected records as outlined below. Providers must then use the established process to resubmit any record with an exception or rejection. The State, DXC, and Sandata are not able to determine this process. This is not a new requirement.

Visit Record Exceptions

Providers must correct visit record exceptions by either acknowledging or correcting them in the Alternate EVV system, through the process established with the Alternate EVV vendor.

For example, providers should work with their Alternate EVV vendor to determine the process for: 

1. How to identify a client signature exception.
2. How to acknowledge the exception.

You can review visit records in either the “Aggregator Visit Review” or through the “Aggregator Report Review” in the Sandata Portal. The table below shows all possible incomplete visit exceptions and the action needed to correct them. For a list of exceptions and their descriptions as well as more detail about how to acknowledge and correct exceptions, see the Electronic Visit Verification Participant Guide. Note: GPS must be enabled on all Alternate EVV vendor systems and resulting exceptions cannot be altered.

 

Incomplete Visit Exceptions
Exception	Resolution
Client Signature Exception	Acknowledge
GPS Distance Exception	Enabled
Missing Service	Fix
Service Verification Exception	Acknowledge
Unauthorized Service	Fix
Unknown Clients	Fix
Unknown Employees	Fix
Unmatched Client ID / Phone	Acknowledge
Visit Verification Exception	Acknowledge
Visits Without In-Calls	Fix
Visits Without Out-Calls	Fix

  

Rejected Visit Records

Rejected visit records must be corrected by the provider or their Alternate EVV vendor and resubmitted. Rejections can happen two ways:

• The entire file could be rejected if the file format is incorrect or has other unexpected or missing information, such as data elements that are out of sequence.
• Individual records can be rejected if there is unexpected or missing information, such as no Member ID.    

For technical questions about this process, please contact:

• MaineCare's EVV email box
• Provider Services at 1-866-690-5585, option 3

Please visit MaineCare’s EVV webpage for more information.